French Helen P, Hager Charlotte K, Venience Anne, Fagan Ryan, Meldrum Dara
School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland.
Department of Community Medicine and Rehabilitation, UMEA University, Sweden.
Int J Rehabil Res. 2020 Jun;43(2):102-115. doi: 10.1097/MRR.0000000000000403.
Individuals with knee osteoarthritis (OA) commonly demonstrate impaired postural control. We aimed to systematically review psychometric properties of tests that assess postural control in people with knee OA and secondly, to determine domains of postural control measured by these tests. PubMed, CINAHL, Embase and Web of Science databases were searched to January 2019. Two independent review authors screened references according to eligibility criteria. The Consensus-based Standards for the selection of health Measurement Instruments were used to evaluate study methodological quality. Postural control tests identified from included studies were assessed to determine postural control constructs using the Systems Framework for Postural Control identifying nine domains. Following the screening of 2643 references, five cross-sectional studies and one longitudinal study (n = 408) were included. Four studies evaluated reliability, validity or responsiveness of three clinical measures: Community Balance and Mobility Scale, Star Excursion Balance Test and Tinetti Performance Oriented Mobility Assessment. Two assessed reliability or validity of a force platform. Results showed that evidence for reliability, validity and responsiveness of all these postural measures is limited. The most common domain of postural control assessed was 'static stability'. No study used measures that evaluated all nine postural control domains. Our results highlight limited investigation of psychometric properties specific to postural control in knee OA. The few existing ones have limitations regarding psychometric robustness and completeness regarding different domains of postural control. Future research should focus on verifying the quality of existing tools to evaluate postural control in knee OA for research and clinical purposes.
膝骨关节炎（OA）患者通常表现出姿势控制受损。我们旨在系统回顾评估膝OA患者姿势控制的测试的心理测量特性，其次，确定这些测试所测量的姿势控制领域。检索了截至2019年1月的PubMed、CINAHL、Embase和Web of Science数据库。两位独立的综述作者根据纳入标准筛选参考文献。采用基于共识的健康测量工具选择标准来评估研究方法的质量。对纳入研究中确定的姿势控制测试进行评估，以使用姿势控制系统框架确定九个领域来确定姿势控制结构。在筛选了2643篇参考文献后，纳入了五项横断面研究和一项纵向研究（n = 408）。四项研究评估了三种临床测量方法的信度、效度或反应性：社区平衡与移动量表、星形偏移平衡测试和Tinetti以性能为导向的移动性评估。两项研究评估了测力平台的信度或效度。结果表明，所有这些姿势测量方法的信度、效度和反应性的证据都很有限。评估的最常见的姿势控制领域是“静态稳定性”。没有研究使用评估所有九个姿势控制领域的测量方法。我们的结果突出了对膝OA中特定于姿势控制的心理测量特性的研究有限。现有的少数研究在心理测量稳健性和姿势控制不同领域的完整性方面存在局限性。未来的研究应侧重于验证现有工具在研究和临床目的下评估膝OA姿势控制的质量。
